Dr. Donohue: Fatigue, sleepiness two different conditions

DR. PAUL DONOHUESyndicated Columnist

Published Friday, June 24, 2005

DEAR DR. DONOHUE: I am tired all the time, and I wonder if I get enough sleep. I sleep between seven and eight hours a night. What's the recommendation? My wife says I have chronic fatigue syndrome. Would vitamins help me? What would? -- O.S.

ANSWER: Fatigue and sleepiness are not the same thing. The distinction is important. Sleepiness is the inability to stay awake during the day, and its causes are many. Narcolepsy is one example. Too little sleep time is another. The recommended hours of sleep vary from person to person. The amount of sleep needed is the amount of sleep that makes a person feel rested the following day. For most people, that averages about eight hours.

Fatigue is exhaustion that is not abolished by rest. Even eight hours of sleep cannot undo fatigue. Chronic fatigue syndrome is a complex condition whose main symptom is a lack of energy for an extended period of time even when the person gets sufficient sleep. Before a doctor can make that diagnosis, all fatigue-causing illnesses must be explored -- depression, sleep apnea, anemia, a poorly functioning thyroid gland and illnesses such as rheumatoid arthritis.

If a doctor makes a diagnosis of chronic fatigue syndrome, the battle to overcome it is a protracted one. Vitamins don't help. There is no Food and Drug Administration-approved medicine for it, but sometimes a stimulant drug like Ritalin is given a brief trial to test its effectiveness.

More than drugs, a supervised, structured exercise program is better medicine. Such a program begins modestly with a short walk. From that point, the time and tempo of the walk are gradually increased until the person can manage half an hour of brisk walking every day. If people with chronic fatigue syndrome plunge into an overly ambitious exercise program, they can make matters worse. Slow progress is the key to success.

The booklet on chronic fatigue syndrome gives the details of this illness and its treatments. Readers can obtain a copy by writing: Dr. Donohue -- No. 304, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient's printed name and address. Please allow four weeks for delivery.